2017年美国护士资格认证(CGFNS)真题及标准答案

美国护士资格认证(CGFNS)试卷2017年

(总分：100.00，做题时间：180分钟)

一、单项选择题（共50题，每题2分。每题的备选项中，只有一个最符合题意）(总题数：50，分数：100.00)

1.The nurse is teaching a client about using vaginal medications. The nurse should instruct the client （）

（分数：2.00）

e a tampon after insertion to increase medication absorption.

B.release and pull up on the applicator before removal.

C.never refrigerate suppositories.

e only a water-soluble lubricant when inserting a suppository. √

解析：The nurse should instruct the client to use only a water-soluble lubricant when inserting a suppository. Tampons shouldn’t be used because the tampon will absorb some medication, making the medication less effective. When removing the applicator, the client should keep the plunger depressed. Suppositories may be refrigerated to keep their form.

2.A male client with a total hip replacement is progressing well and expects to be discharged tomorrow. On returning to bed after ambulating, he complains of severe pain in the surgical wound. Which action should the nurse take（）

（分数：2.00）

A.Assume he’s anxious about discharge, and administer pain medication.

B.Assess the surgical site and affected extremity. √

C.Reassure the client that pain is a direct result of increased activity.

D.S uspect a wound infection, and monitor the client’s temperature and vital signs.

解析：Worsening pain after a total hip replacement may indicate dislocation of the prosthesis. Assessment of pain should include evaluation of the wound and the affected extremity. Assuming he’s anxious about discharge and administering pain medication don’t address the cause of the pain. Sudden severe pain isn’t normal after hip replacement. Wound infections are usually distinguished by purulent drainage.

3.A 4-year-old girl is admitted to the hospital to rule out leukemia. Which of the following would be the best room assignment（）

（分数：2.00）

A.With a 4-year-old girl who has rheumatoid arthritis.

B.With a 5-year-old boy who is having a tonsillectomy.

C.With a 4-year-old girl who has leukemia.

D.Alone in a private room. √

解析：Avoiding exposure to infection requires a private room.

4.A client is to have a cesarean delivery because of continuous vaginal bleeding and an abnormal fetal heart rate tracing. Which of the following would be the best preoperative medication for this client（）

（分数：2.00）

A.Meperidine (Demerol).

B.Oxytocin (Pitocin).

C.Promethazine (Phenergan).

D.Glycopyrrolate (Robinul). √

解析：Glycopyrrolate is a parasympatholytic that will decrease the risk of aspiration. Meperidine and promethazine can cause central nervous system and respiratory depression in neonates. Oxytocin precipitates labor.

5.An elderly client with Alzheimer’s disease begins supplemental tube feedings through a gastrostomy tube to provide adequate calorie intake. The nurse should be concerned most with the potential for（）

（分数：2.00）

A.hypoglycemia.

B.fluid volume excess.

C.aspiration. √

D.constipation.

解析：Of the choices listed, aspiration is the most serious potential complication of tube feedings. Dehydration--not fluid volume excess--is a concern because of decreased free water intake. Hyperglycemia, not hypoglycemia, is a complication secondary to carbohydrate load of enterat feeding solutions. Constipation is a problem, but it usually isn’t a serious one. The client would most likely experience diarrhea.

6.The nurse is administering warfarin (Coumadin) to a client with deep vein thrombophlebitis. Which laboratory value indicates warfarin is at therapeutic levels（）

（分数：2.00）

A.Partial thromboplastin time (PTT) 1 1/2 to 2 times the control.

B.Prothrombin time (PT) 1 1/2 to 2 times the control. √

C.International normalized ratio (INR) of 3 to 4.

D.Hematocrit of 32%.

解析：Warfarin is at therapeutic levels when the client’s PT is 1 1/2 to 2 times the control. Higher values indicate increased risk of bleeding and hemorrhage; whereas lower values indicate increased risk of blood clot formation. Heparin--not warfarin--prolongs PTT. The INR may also be used to determine if warfarin is at a therapeutic level. An INR of 2 to 3 is considered therapeutic. Hematocrit doesn’t provide information on the effectiveness of warfarin; however,

a falling hematocrit in a client taking warfarin may be a sign of hemorrhage.

7.The nurse teaches a mother how to provide adequate nutrition for her toddler, who has cerebral palsy. Which of the following observations indicates that teaching has been effective（）

（分数：2.00）

A.The toddler stays neat while eating.

B.The toddler finishes the meal within a specified period of time.

C.The child lies down to rest after eating.

D.The child eats finger foods by himself. √

解析：The child with cerebral palsy should be encouraged to be as independent as possible. Finger foods allow the toddler to feed himself. Because spasticity affects coordinated chewing and swallowing as well as the ability to bring food to the mouth, it’s difficult for the child with cerebral palsy to eat neatly. Independence in eating should take precedence over neatness. The child with cerebral palsy may require more time to bring food to the mouth; thus, chewing and swallowing shouldn’t be rushed to finish a meal by a specified time. The child with cerebral palsy may vomit after eating, due to a hyperactive gag reflex. Therefore, the child should remain in an upright position after eating to prevent aspiration and choking.

8.The nurse is giving instructions to a client who is going home with a cast on his leg. Which point is most critical（）

（分数：2.00）

ing crutches properly.

B.Exercising joints above and below the cast, as ordered.